Cost Research Methodology

Reviewed by KW Life Care Planning Editorial Team

Cost research is the process by which each item in a life care plan receives a unit price that reflects what the care actually costs where the evaluee lives. It combines geographically matched pricing sources, direct provider and vendor quotes, and documentation sufficient for another planner to reproduce the figure.

When it is used

Every life care plan and medical cost projection rests on cost research. It is scrutinized most closely on high-dollar items: attendant care, residential placement, surgical revisions, and durable equipment with short replacement cycles. It is also the first place a rebuttal reviewer looks.

Step-by-step

  1. Define each item precisely enough to price: the service or product, the setting, the level of provider, the quantity, and the frequency
  2. Identify the geographic market in which the care will be delivered, which is usually where the evaluee lives, not where the planner practices
  3. Select a pricing basis appropriate to the item: provider and vendor quotes, recognized usual-and-customary charge data, published fee schedules, or facility rate sheets
  4. Collect at least one quote or data point per item and, for significant items, more than one, recording the source, contact, date, and any assumptions
  5. Reconcile the sources into a stated unit cost, explaining any choice among divergent figures
  6. Record the research in the plan or its work file so that each cost can be traced and re-priced at a later update

Data sources

Limitations

Prices vary by payer, setting, and provider, and a quote is a snapshot. A plan that mixes charge data with paid-amount data without explanation, or that prices care in the wrong market, is vulnerable. Costs are refreshed at each plan update, which is why the plan states the research date for each item.

Admissibility

Documented, geographically matched cost research following the IALCP standards is widely accepted (Reavis, 2002). Challenges succeed when the source of a price cannot be identified or when the planner cannot explain why one figure was chosen over another.

Frequently Asked Questions

Should a life care plan use billed charges or amounts actually paid?

It depends on the jurisdiction's rules on the measure of medical damages and on what the evaluee will actually face. The planner should state which basis was used for each category and why, so counsel can align the plan with the governing rule.

How many quotes does an item need?

There is no fixed number. One documented source may suffice for a low-cost, standardized item; significant or unusual items warrant several sources and a reconciliation. What matters is that the basis is recorded and reproducible.

Why not use a national average?

A national average may bear no relationship to the price of care in the evaluee's community. The standard is the cost of care in the relevant geographic market, and a plan should say what market that is.

References

Discuss how this applies to your case

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